The ABCs of measuring intracerebral hemorrhage volumes

Background and Purpose Hemorrhage volume is a powerful predictor of 30-day mortality after spontaneous intracerebral hemorrhage (ICH). We compared a bedside method of measuring CT ICH volume with measurements made by computer-assisted planimetric image analysis. Methods The formula ABC/2 was used, where A is the greatest hemorrhage diameter by CT, B is the diameter 90 degrees to A, and C is the approximate number of CT slices with hemorrhage multiplied by the slice thickness. Results The ICH volumes for 118 patients were evaluated in a mean of 38 seconds and correlated with planimetric measurements (R(2) = .96). Interrater and intrarater reliability were excellent, with an intraclass correlation of .99 for both. Conclusions We conclude that ICH volume can be accurately estimated in less than 1 minute with the simple formula ABC/2.